Thursday, October 24, 2013

HIPPA didn't stand a chance!

I'm not sure why the ICU was built with "semi-private" rooms. If I'd been asked I would have said 1 patient per, but they neglected to ask my opinion on a lot of things (don't even get me started on the panic-off-switch on the ceiling: pull on the call light cord & your nurse gets to try to push a dime sized button on the 12-ft ceiling above your head with whatever she can find to poke with, it's a "safety feature" until she drops whatever she was poking with on your face). In an age where privacy is a diminishing commodity & laws protect your private information, single-occupant rooms in an ICU seems like it would have been a given.
Luckily, most patients are too sick to pay attention to anyone else's business or polite enough to stop listening to the other side of that curtain. Most patients. And then you get the busybody patient--at least the roommate is stable & gets to go home to escape from busybody's bat-like hearing. But unfortunately not before BB picks up a few tidbits, but it's not so bad that a stranger overheard your first name, right? Except the next unfortunate roommate is deaf as a post, which only aids in BBs search for  entertainment (because, hey, just because you have access to a ludicrously large supply of opioids & hypnotic sedatives doesn't mean you want to be restricted to your own business or the available 60 channels of cable).
At first I felt bad that my required shouting at DPost would wake up BB.  I offered BB both earplugs & headphones which were refused. Shouldn't have concerned myself, BB wasn't sleeping, just lying in wait. Waiting to insure hot my dressing changes, turning, giving meds, shouting through the curtain about your latest "emergency": "there's a clock on the wall, but that time is wrong, it's not 5!" (It was 0507), or "that doctor missed me, you have to call him back! I'm just as important" (it was completely different kind of physician than had anything to do with her case).
Fast-forward to day 2 of BB's stay, well technically 2AM on day 3; I'm taking care of my patient DPost: "ma'am! Ma'am! Excuse me, ma'am!" (This is not a strong way to start with me unless your 20 & in the military).
I abhor yelling through curtains to patients, but there are some activities that can't be interrupted & some voices that can't be ignored. "I'm taking care of another patient right now, do you need something?"
"Ma'am, you're calling that guy the wrong name! His name isn't Fred*! His name is Bill*" BB may have had a point, the previous patient was Bill, but both the new patients' wife & prior nurse had assured me that DPost's name is Fred.
"It's ok, you don't need to worry about the patient over here, I've got it under control"
"It's a good thing I'm worrying! That's not Fred, that's Bill & I'm stopping you from making a mistake"
Given that it was 0200, I did double check DPost's ID band to confirm that yes, this is Fred. "I know what this patient's name is. I appreciate your concern, but--"
"I don't like your attitude! You're being very rude!" Ironically, I had to work very hard from telling her to shut up & mind her own business. Isn't eavesdropping on your neighbor pretty rude? And if you're going to go through the trouble of eavesdropping, how did you not hear all of Bill's discharge instructions? Or the fact that an entirely new patient arrived--I was later told that BB complained that he room was being cleaned too loudly after original recipe left.
At this point I just stopped responding.   Fred obviously is responding to his name, talking back to me,  but BB keeps in carrying on. I wonder if BB overheard the double nurse, ID band check 2 hours later when I had to give DPost a transfusion. But for the first time in 2 days she didn't try to get the last word.

So if you're gonna eavesdrop, at least eavesdrop well & keep your characters straight. And if you're gonna build an ICU, ask the nurses for advice before they start designing nooses out of call-light cords for you.



*names are changed for privacy's sake! Isn't that the whole point?